| 1. |
- Palmryd, Lena, Doktorand, et al.
(författare)
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Integrity at end of life in the intensive care unit : a qualitative study of nurses' views.
- 2021
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Ingår i: Annals of Intensive Care. - : Springer Science and Business Media LLC. - 2110-5820 .- 2110-5820. ; 11:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Integrity is a core value for delivering ethical health care. However, there is a lack of precision in defining what integrity is and how nurses understand it. In the setting of nurses caring for critically ill and dying patients in intensive care units (ICUs), integrity has not received much attention. Therefore, the aim of this study was to explore how nurses perceive and maintain the integrity of patients during end-of-life care in the ICU setting.METHODS: This study had a qualitative descriptive design. Data were collected using individual semi-structured interviews with 16 intensive care nurses working at ICUs in four Swedish hospitals. The data were analysed by applying qualitative content analysis.RESULTS: Five overall categories were explored: seeing the unique individual; sensitive to patient vulnerability; observant of patients' physical and mental sphere; perceptive of patients' religion and culture; and being respectful during patient encounters. Many nurses found it difficult to define integrity and to explain what respecting integrity entails in the daily care of dying patients. They often used notions associated with respect and patient-centred attitudes, such as listening and being sensitive or by trying to describe good care. Integrity was nonetheless seen as a central value for their clinical work and a precondition for ethical nursing practice. Some nurses were concerned about patient integrity, which is at risk of being "wiped out" due to the patient's illness/injury, unfamiliarity with the ICU environment and utter dependence on others for care. Protecting patients from harm and reducing patient vulnerability were also seen as important and a way to maintain the integrity of patients.CONCLUSIONS: The study results show that even though integrity is a fundamental ethical concept and a core value in nursing, ethical codes and guidelines are not always helpful in clinical situations in the end-of-life care of ICU patients. Hence, opportunities must regularly be made available for ICU nurses to reflect on and discuss ethical issues in terms of their decision-making and behaviour.
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| 2. |
- Pennbrant, Sandra, 1967-, et al.
(författare)
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Mastering the professional role as a newly graduated registered nurse
- 2013
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 33:7, s. 739-745
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Tidskriftsartikel (refereegranskat)abstract
- Professional development is a process starting during undergraduate education and continuing throughout working life. A new nurse's transition from school to work has been described as difficult. This study aims to develop a model describing the professional development of new nurses during their first years of work. To develop this model, constant comparative analyses were performed. The method was a qualitative study of survey data on 330 registered nurses. The results showed that mastering the professional role was the result of an ongoing process building on the nurse's experiences and interactions with the surrounding environment. The professional developmental process involves the following interrelated sub-processes: evaluating and re-evaluating educational experiences, developing professional self-efficacy and developing clinical competence. These sub-processes are influenced by the following factors: social values and norms, healthcare organization, management of new nurses, co-workers, patients and significant others and the nurse's own family and friends. These factors affect professional development directly, indirectly or as mediating influences and can lead to possible outcomes, as new nurses choose to remain in or leave the profession. The results underscore the importance of developing a professional nursing role within the new working context. To facilitate this professional development, new nurses need support from their nursing-school educators and their healthcare employers. The model described here will be the subject of further measurement and testing. © 2012 Elsevier Ltd.
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| 3. |
- Rejnö, Åsa, 1970-, et al.
(författare)
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Dignity at stake : Caring for persons with impaired autonomy
- 2020
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 27:1, s. 104-115
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Tidskriftsartikel (refereegranskat)abstract
- Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient's dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient's wishes and needs are the starting point.
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| 4. |
- Rejnö, Åsa, 1970-, et al.
(författare)
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Reasoning about truth-telling in end-of-life care of patients with acute stroke
- 2017
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 24:1, s. 100-110
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Ethical problems are a universal phenomenon but rarely researched concerning patients dying from acute stroke. These patients often have a reduced consciousness from stroke onset and thereby lack ability to convey their needs and could be described as 'incompetent' decision makers regarding their own care. OBJECTIVE: The aim of the study was to deepen the understanding of stroke team members' reasoning about truth-telling in end-of-life care due to acute stroke. RESEARCH DESIGN: Qualitative study based on individual interviews utilizing combined deductive and inductive content analysis. PARTICIPANTS AND RESEARCH CONTEXT: A total of 15 stroke team members working in stroke units of two associated county hospitals in western Sweden participated. ETHICAL CONSIDERATIONS: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. FINDINGS: The main findings were the team members' dynamic movement between the categories 'Truth above all' and 'Hide truth to protect'. Honesty was highly valued and considered as a reason for always telling the truth, with the argument of truth as common morality. However, the carers also argued for hiding the truth for different reasons such as not adding extra burden in the sorrow, awaiting a timely moment and not being a messenger of bad news. Withholding truth could both be seen as a way of protecting themselves from difficult conversations and to protect others. DISCUSSION: The results indicate that there are various barriers for truthfulness. Interpreted from a virtue of ethics perspective, withholding of truth might also be seen as an expression of sound judgement to put the patient's best interest first. CONCLUSION: The carers may need support in the form of supervision to be given space to reflect on their experience and thereby promote ethically justified care. Here, the multi-professional team can be of great value and contribute through inter-professional sharing of knowledge.
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| 5. |
- Sorbring, Emma, 1972-, et al.
(författare)
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Våld och kränkningar i ungas parrelationer
- 2018
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Ingår i: Barn- och ungdomsvetenskap. - Stockholm : Liber. - 9789147113071 ; , s. 622-637
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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